Provider Demographics
NPI:1881002541
Name:UJIMA FAMILY RECOVERY SERVICES
Entity type:Organization
Organization Name:UJIMA FAMILY RECOVERY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-236-3139
Mailing Address - Street 1:1901 CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3707
Mailing Address - Country:US
Mailing Address - Phone:510-236-3139
Mailing Address - Fax:510-236-3200
Practice Address - Street 1:12960 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-1307
Practice Address - Country:US
Practice Address - Phone:510-215-2280
Practice Address - Fax:510-215-2283
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UJIMA FAMILY RECOVERY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-25
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility